WGIUPD
DIVISION:
GENERAL INFORMATION SYSTEM
Office of Health Insurance Programs
5/15/14
PAGE 1
GIS 14 MA/11
TO:
Local District Commissioners, Medicaid Directors
FROM:
Judith Arnold, Director
Division of Eligibility and Marketplace Integration
SUBJECT:
Third Party Health Insurance – CHAMP-VA
EFFECTIVE DATE:
Immediately
CONTACT PERSON:
Local District Support Unit
Upstate (518) 474-8887
NYC
(212) 417-4500
The purpose of this General Information System (GIS) message is to remind
local departments of social services (LDSS) that when an individual is
enrolled in CHAMP-VA, the insurance must be entered into eMedNY as a
Commercial Health Insurance policy. The insurance code for CHAMP-VA is CVA.
CHAMP-VA is insurance available to the spouse or widow(er) and children of a
military beneficiary who is not eligible for TRICARE. CHAMP-VA is available
to the family members of a military beneficiary who:
 is rated permanently and totally disabled due to a service connected
disability;
 was rated permanently and totally disabled due to a service connected
condition at the time of death;
 died of a service connected disability; or
 died on active duty, and the dependents are not otherwise eligible for
TRICARE benefits.